| NPI | 1710239751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: AZ 55263) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 55263) |
| Enumeration Date | 2012-10-14 |
| Last Update Date | 2019-05-01 |