| NPI | 1164502076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: NH 10171) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME 017615) |
| 207W00000X Ophthalmology (Licence: NH 10171) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2017-08-16 |