| NPI | 1669451951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0051788) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD438329) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2012-09-28 |