| NPI | 1548359821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101040992) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD16595) |
| 207W00000X Ophthalmology (Licence: MD D0034058) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2019-08-06 |