| NPI | 1013984848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD418865) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0029740) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2020-09-17 |