| NPI | 1356341119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 045447) |
| Additional Taxonomies | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: GA 045447) |
| 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: GA 045447) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2023-02-28 |