NPI | 1316523921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MN 80152) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 80152) |
Enumeration Date | 2021-03-23 |
Last Update Date | 2025-08-14 |