| NPI | 1639143993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0004150) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101018821) |
| 207W00000X Ophthalmology (Licence: DC MD3618) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2010-05-05 |