| NPI | 1235192568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0051136) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD069168L) |
| 207W00000X Ophthalmology (Licence: DC MD041974) | |
| 207W00000X Ophthalmology (Licence: VA 0101255442) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2022-08-12 |