| NPI | 1407234461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME139337) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: FL ME139337) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2023-09-12 |