| NPI | 1528387610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: OH 35.138320) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME112753) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2020-01-08 |