| NPI | 1952979957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-53930) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 9029-851) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-09-03 |