| NPI | 1770587362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR md11350) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AK md3909) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2022-10-13 |