| 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 |