| NPI | 1912097171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD431622) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2005-00363) |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: PA MD431622) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-10-09 |