| NPI | 1427055227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME26952) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME0026952) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-09-10 |