| NPI | 1013984848 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0029740) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD418865) | 
| Enumeration Date | 2006-03-01 | 
| Last Update Date | 2024-12-12 |