| NPI | 1922030907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D67936) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301082293) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-05-29 |