| NPI | 1760841704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: FL ME135977) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL MFC1752) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2019-06-10 |