| NPI | 1750355905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101016788) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0012751) |
| 207W00000X Ophthalmology (Licence: DC MD2607) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2009-12-08 |