| NPI | 1902933286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0041347) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD18935) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2024-01-04 |