| NPI | 1245799519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL OS20850) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA 20A20884) |
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL OS20850) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL OS20850) | |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2024-05-10 |