| NPI | 1689674921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD022743E) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: PA MD022743E) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2019-05-02 |