| NPI | 1538503834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD d85445) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 270023) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2022-07-21 |