| NPI | 1568418283 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME-22567) | 
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0022567) | 
| Enumeration Date | 2006-05-25 | 
| Last Update Date | 2016-03-14 |