| NPI | 1114999729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: AL 21881) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME68947) |
| 207W00000X Ophthalmology (Licence: NY 198405-1) | |
| 207W00000X Ophthalmology (Licence: MS 17168) | |
| 207W00000X Ophthalmology (Licence: AL 21881) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2023-10-24 |