| NPI | 1841388907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G24447) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G24447) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2019-10-17 |