| NPI | 1275560575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD006852) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0029171) |
| 207W00000X Ophthalmology (Licence: VA 0101037838) | |
| 207W00000X Ophthalmology (Licence: FL ME80732) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2008-05-23 |