| NPI | 1609363829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-49577) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: IA MD-49577) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2022-08-01 |