| NPI | 1659474872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0070213) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD439005) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2015-08-03 |