| NPI | 1518963677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: ME MD16500) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME 016500) | 
| Enumeration Date | 2005-06-23 | 
| Last Update Date | 2023-10-12 |