| NPI | 1841457652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CA 151227) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101258022) |
| 207W00000X Ophthalmology (Licence: MD D0074509) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-07-21 |