| NPI | 1477523496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CT 40025) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 040025) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2017-11-02 |