| NPI | 1326006917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2022037578) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 2899121205) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: UT 2899121205) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MO 2022037578) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-04-12 |