| NPI | 1578543781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD061634L) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: PA MD061634L) |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: PA MD061634L) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: PA MD061634L) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2023-06-23 |