| NPI | 1174521264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D-0055876) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0005940) |
| 207W00000X Ophthalmology (Licence: MD D0055876) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: DE C1-0005940) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: MD D0055876) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2020-09-28 |