| NPI | 1528293594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME131570) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A123591) |
| 207W00000X Ophthalmology (Licence: FL ME131570) | |
| 207W00000X Ophthalmology (Licence: VA 0101254707) | |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2026-06-02 |