| NPI | 1457381410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: DC MD034763) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D61336) |
| 207W00000X Ophthalmology (Licence: VA 0101237403) | |
| 207W00000X Ophthalmology (Licence: FL ME96863) | |
| 207W00000X Ophthalmology (Licence: DC DO061336) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2022-09-20 |