| NPI | 1821226697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 5101018152) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: WY 10170A) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2020-12-04 |