| NPI | 1295705697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: UT 3591001205) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: UT 983591001205) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2017-04-13 |