| NPI | 1568468635 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: ME MD15011) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME 015011) | 
| Enumeration Date | 2005-06-23 | 
| Last Update Date | 2020-04-21 |