| NPI | 1457556003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: WV 23805) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX M7472) |
| 207W00000X Ophthalmology (Licence: WV 23805) | |
| 207W00000X Ophthalmology (Licence: MA 233738) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2022-04-12 |