| NPI | 1376518399 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL ME105047) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME105047) | 
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME105047) | |
| 174400000X Specialist (Licence: PA MD426523) | |
| Enumeration Date | 2006-02-22 | 
| Last Update Date | 2019-04-19 |