| NPI | 1215687629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101288695) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0106232) |
| 207W00000X Ophthalmology (Licence: DC MD600005519) | |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2026-10-06 |