| NPI | 1386724334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0066906) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD061305L) |
| 207W00000X Ophthalmology (Licence: NY 176966-1) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2010-09-24 |