| NPI | 1861585440 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0033735) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD14667) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-09-01 |