| NPI | 1538144423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX J0106) |
| Additional Taxonomies | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: TX J0106) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2019-01-30 |