| NPI | 1477521334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0050019) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD059877L) |
| 207W00000X Ophthalmology (Licence: NM MD2014-0756) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0050019) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD059877L) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2014-0756) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2020-04-15 |