| NPI | 1134700719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: WI 82077-21) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX V6616) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2026-07-03 |