| NPI | 1235302183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NV 15092) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A104124) |
| 207W00000X Ophthalmology (Licence: FL ME 112756) | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2020-02-06 |