| NPI | 1770840720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 290244) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 57.022527) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: AL 34921) | |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2021-04-20 |