| NPI | 1033377973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: WA MD60367839) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD60367839) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: OR MD153690) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2019-11-12 |