| NPI | 1275776049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0075771) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101253627) |
| 207W00000X Ophthalmology (Licence: PA MD454038) | |
| 207W00000X Ophthalmology (Licence: WV 26567) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0075771) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD454038) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WV 26567) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101253627) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2020-04-15 |