| NPI | 1316905839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: TX N5646) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G85368) |
| 207W00000X Ophthalmology (Licence: TX N5646) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2018-04-19 |