| NPI | 1790728202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101287250) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0056298) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2026-05-05 |