| NPI | 1124053350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0068533) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD037765) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0068533) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101244791) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD037765) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2018-09-13 |