| NPI | 1659790830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: LA 306772) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 306772) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-07-27 |