| NPI | 1821190877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD417671) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C10006233) |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: PA MD417671) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-04-27 |