| NPI | 1548332042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D55947) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101225408) |
| 207W00000X Ophthalmology (Licence: DC MD21805) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2014-01-29 |