| NPI | 1801983473 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A72027)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 53806)  | 
| 207W00000X Ophthalmology (Licence: NY 250473)  | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 250473)  | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CA A72027)  | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: AZ 53806)  | |
| Enumeration Date | 2006-10-06 | 
| Last Update Date | 2021-05-03 |