| NPI | 1760432405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME80332) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME0080332) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-08-31 |