| NPI | 1497147680 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL OS16173) | 
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL OS16173) | 
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS16173) | |
| Enumeration Date | 2015-02-24 | 
| Last Update Date | 2023-04-11 |