| NPI | 1952442253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 101042795) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD30373) |
| 207W00000X Ophthalmology (Licence: MD D0052312) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2025-07-25 |