| NPI | 1235617051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-49699) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC LL61212) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: IA MD-49699) | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2022-08-19 |