| NPI | 1861603524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D74823) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT189272) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2024-02-15 |