| NPI | 1114487972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0102596) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101285261) |
| 207W00000X Ophthalmology (Licence: DC MD600003666) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-08-12 |