| NPI | 1174568695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0071125) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 101248322) |
| 207W00000X Ophthalmology (Licence: CT 044051) | |
| 207W00000X Ophthalmology (Licence: DC MD038903) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-03-07 |