| NPI | 1588125876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CO DR.0075737) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 13315183-1205) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-09-30 |