| NPI | 1225091473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: FL 41105) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 0041105) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2016-05-02 |