| NPI | 1336101740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: MI 4301091699) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 430109169) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2023-09-09 |