| NPI | 1740868975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MI 4301512667) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301512667) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2025-11-18 |