| NPI | 1831176312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME 013866) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 9375) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-06-29 |