| NPI | 1922053602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0041632) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD18973) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-05-06 |