| NPI | 1447773296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: FL ME132877) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME132877) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2017-07-24 |