| NPI | 1912529959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME168453) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: FL ME168453) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2024-07-23 |