| NPI | 1750700746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301114144) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA 4301114144) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MI 4301114144) | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2022-07-19 |