| NPI | 1366436412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 188029-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT 188029-1205) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: UT 188029-1205) | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2021-11-11 |