| NPI | 1235116062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD044144) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D59403) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-08-03 |