| NPI | 1952697773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101262441) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD045044) |
| 207W00000X Ophthalmology (Licence: PA MD453961) | |
| 207W00000X Ophthalmology (Licence: VA 0101262441) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD045044) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2019-04-09 |