| NPI | 1124044979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: TX T2801) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A60994) |
| 207W00000X Ophthalmology (Licence: MD D73128) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-10-04 |