| NPI | 1902850522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 265473) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0063365) |
| 207W00000X Ophthalmology (Licence: VA 0101238411) | |
| 207W00000X Ophthalmology (Licence: DC MD035584) | |
| 207W00000X Ophthalmology (Licence: PA MD430902) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2013-06-27 |