| NPI | 1851354500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0058545) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD490205C) |
| 207W00000X Ophthalmology (Licence: VA 0101248431) | |
| 207W00000X Ophthalmology (Licence: DC MD038929) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2026-03-21 |