| NPI | 1295354579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NC 2024-00949) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 202400949) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2026-09-12 |