| NPI | 1639375397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM MD2016-0152) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-41769) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2023-12-06 |