| NPI | 1891773719 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0012644) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D12644) | 
| Enumeration Date | 2006-01-03 | 
| Last Update Date | 2015-10-01 |