| NPI | 1295013613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD186395) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA MD.207614) |
| 207W00000X Ophthalmology (Licence: MS T-2480) | |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2021-11-10 |