| NPI | 1891857496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD33270) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101238374) |
| 207W00000X Ophthalmology (Licence: MD D0061271) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2021-06-09 |