| NPI | 1477173755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0104162) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 1018597) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2025-06-30 |