| NPI | 1356439020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME97125) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME97125) |
| 207W00000X Ophthalmology (Licence: TX N0706) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-03-07 |