NPI | 1770543571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: FL ME15976) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 0015976) |
Enumeration Date | 2006-03-24 |
Last Update Date | 2018-07-19 |