| NPI | 1992160303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101274430) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D97041) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2023-07-31 |