| NPI | 1174780431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101248654) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD037620) |
| 207W00000X Ophthalmology (Licence: MD D0071577) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2016-09-21 |