| NPI | 1700865052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A98835) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A98835) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CA A98835) | |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2022-01-06 |