| NPI | 1376518944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 32010) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-30330) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-08-12 |