| NPI | 1669440947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: FL ME63362) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME63362) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2022-08-04 |