| NPI | 1275536971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0051444) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD-039313-E) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2012-09-28 |