| NPI | 1740472034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX J5164) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD036424) |
| 207W00000X Ophthalmology (Licence: WV 22617) | |
| 207W00000X Ophthalmology (Licence: VA 0101240902) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2024-04-24 |