| NPI | 1003866484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: CO 44251) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 44251) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-10-09 |