| NPI | 1538143037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MI 4301069798) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301069798) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2017-12-12 |