| NPI | 1275536963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0057303) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD421374) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2012-09-28 |