| NPI | 1598936924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME128721) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 6019935-1205) |
| 207W00000X Ophthalmology (Licence: FL ME128721) | |
| 207W00000X Ophthalmology (Licence: MD D70676) | |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2022-07-21 |