| NPI | 1730160789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 1307) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NV 1307) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2024-01-03 |