| NPI | 1679886576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CA A113129) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A113129) |
| 208200000X Plastic Surgery (Licence: CA A113129) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA A113129) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2020-05-22 |