| NPI | 1326627530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301517607) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0102987) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2026-06-10 |