| NPI | 1417158114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A124021) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A124021) |
| 207W00000X Ophthalmology (Licence: FL ME102139) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2024-04-04 |