| NPI | 1073500047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CT 043082) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 043082) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MA 238678) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2018-08-30 |