| NPI | 1326046897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0051588) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0051588) |
| 207W00000X Ophthalmology (Licence: DC MD20367) | |
| 207W00000X Ophthalmology (Licence: VA 0101053417) | |
| 207W00000X Ophthalmology (Licence: CA G64967) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2010-10-13 |