| NPI | 1205809597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101279927) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD423479) |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: PA MD423479) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: VA 0101279927) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2024-12-17 |