| NPI | 1609920719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL 0044870) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME44870) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2025-02-18 |