| NPI | 1942274808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101058703) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0025073) |
| 207W00000X Ophthalmology (Licence: VA 0101058703) | |
| 207W00000X Ophthalmology (Licence: DC MD31522) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0025073) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2017-07-07 |