| NPI | 1609123694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0085812) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101229155) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2024-09-09 |