| NPI | 1013177682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N9740) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: UT 10382570-1205) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2024-04-30 |