| NPI | 1417419052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A194169) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME162434) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-09-17 |