| NPI | 1528053717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: MN 41668) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 41668) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2017-10-17 |