| NPI | 1144397258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101237596) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 251272) |
| 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: VA 0101237596) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2022-11-29 |