| NPI | 1841458056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 36107) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME-112451) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2013-08-08 |