| NPI | 1841405404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: WA MD60132733) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35090796) |
| 207W00000X Ophthalmology (Licence: WA MD60132733) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2016-05-17 |