| NPI | 1225093149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME0087053) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 236097) |
| 208200000X Plastic Surgery (Licence: NY 236097) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME0087053) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2023-04-28 |