| NPI | 1528262979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-11326) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-050259) |
| 207W00000X Ophthalmology (Licence: OR MD183237) | |
| 207W00000X Ophthalmology (Licence: OH 35.099949) | |
| 207W00000X Ophthalmology (Licence: MO 2011015504) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2018-06-19 |