| NPI | 1932217262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD20277) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0038919) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2019-08-29 |