| NPI | 1730376583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MD D0071864) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301093681) |
| 207W00000X Ophthalmology (Licence: OH 57010750) | |
| 207W00000X Ophthalmology (Licence: MD D0071864) | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2019-02-19 |