| NPI | 1962432260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0065946) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101241092) |
| 207W00000X Ophthalmology (Licence: MD D0065946) | |
| 207W00000X Ophthalmology (Licence: DC MD36645) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD36645) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101241092) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-04-09 |