| NPI | 1528009628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: OH 35069598) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35069598) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-02-17 |