| NPI | 1376566562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME 47615) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME 47615) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-09-13 |