| NPI | 1508182346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD044501) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD447548) |
| 207W00000X Ophthalmology (Licence: MD D82066) | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2016-10-24 |