| NPI | 1144632183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 68627) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 32170) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NE 32120) | |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2026-01-23 |