| NPI | 1538220041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD18670) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101045593) |
| 207W00000X Ophthalmology (Licence: MD D53015) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-06-01 |