| NPI | 1568575389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0016996) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101044148) |
| 207W00000X Ophthalmology (Licence: DC MD9847) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-10-23 |