| NPI | 1235188459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101255091) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0081550) |
| 207W00000X Ophthalmology (Licence: DC MD044692) | |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2016-11-14 |