| NPI | 1871099507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 72215) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: AZ 72215) |
| 208200000X Plastic Surgery (Licence: AZ 72215) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2026-08-29 |