| NPI | 1881654804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D63117) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD062733L) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2013-01-05 |