| NPI | 1366515637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0057311) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101231487) |
| 207W00000X Ophthalmology (Licence: DC MD32023) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-05-27 |