| NPI | 1205893880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CO 0057494) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-55999) |
| 207W00000X Ophthalmology (Licence: WI 33298-020) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: IA MD-55999) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2025-12-30 |