| NPI | 1396737201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME78377) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME78377) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2023-11-30 |