| NPI | 1104834795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0045503) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD460258) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2026-05-15 |