| NPI | 1184670366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD H0062012) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0102201638) |
| 207W00000X Ophthalmology (Licence: DC DO034176) | |
| 207W00000X Ophthalmology (Licence: NJ 25MB08472300) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2012-04-11 |