| NPI | 1407009228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D77069) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP10029901) |
| 207W00000X Ophthalmology (Licence: NY 257134) | |
| 207W00000X Ophthalmology (Licence: DC MD041948) | |
| 207W00000X Ophthalmology (Licence: VA 0101255293) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2014-07-11 |