| NPI | 1316178452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0078912) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD454769) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2015-07-27 |