| NPI | 1184067498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID M-15230) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 67198) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NV 18691) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2022-07-21 |