| NPI | 1114991890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 47926) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 52797-020) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: WI 52797) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2024-09-14 |