| NPI | 1619327434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2022-00529) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NC 2022-00529) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2023-05-01 |