| NPI | 1689674020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD046083L) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD046083L) |
| 207W00000X Ophthalmology (Licence: DE C10005461) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2020-10-09 |