| NPI | 1659716439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD046268) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0082993) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2018-09-24 |