| NPI | 1457311839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101032050) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0021492) |
| 207W00000X Ophthalmology (Licence: DC MD12609) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2009-12-08 |