| NPI | 1518027036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD19685) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME59871) |
| 207W00000X Ophthalmology (Licence: MD D0043365) | |
| 207W00000X Ophthalmology (Licence: VA 0101048340) | |
| 207W00000X Ophthalmology (Licence: CA G86158) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2011-11-14 |