| NPI | 1184614000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 27103) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME57196) |
| 207W00000X Ophthalmology (Licence: AZ 16751) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME57196) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MN 27103) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: AZ 16751) | |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2020-08-12 |