| NPI | 1275039877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2023012406) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0093855) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2023-06-06 |