| NPI | 1801156328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 56321) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CO 56321) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2022-02-22 |