| NPI | 1831163997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101042520) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0037044) |
| 207W00000X Ophthalmology (Licence: VA 0101042520) | |
| 207W00000X Ophthalmology (Licence: DC MD17393) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD17393) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-07-27 |