| NPI | 1194875864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D70837) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT188147) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MD D70837) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2016-04-29 |