| 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 |