| NPI | 1508043597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV MD7268) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NV MD7268) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |