| NPI | 1417914896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 200700649) |
| Additional Taxonomies | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: NC 200700649) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2023-07-20 |