| 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: WI 33298-020) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2017-04-26 |