| NPI | 1558003525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD493441) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0116036381) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2026-08-20 |