| NPI | 1225016959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 39825) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-43037) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2020-08-18 |