| NPI | 1205878378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: MD D57483) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: VA 0101055380) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-11-14 |