| NPI | 1548265374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD044041E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD-044041-E) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-11-29 |