| NPI | 1992878144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME65902) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME65902) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-03-23 |