| NPI | 1730101973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME101225) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME101225) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-04-30 |