| NPI | 1982681367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME 011998) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 56003) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2018-09-14 |