| NPI | 1356364061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology Neuro-ophthalmology (Licence: AL 20851) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 00020851) |
| 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: AL 20851) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-07-09 |