| NPI | 1366804858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME145329) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME145329) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2025-07-24 |