| NPI | 1932190121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CO 37140) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-27845) |
| 207W00000X Ophthalmology (Licence: WY 6502A) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CO 37140) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: MI 4301067317) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: KS 04-27845) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NE 18881) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: MA 156104) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: WY 6502A) | |
| 207W00000X Ophthalmology (Licence: MI 4301067317) | |
| 207W00000X Ophthalmology (Licence: CO 37140) | |
| 207W00000X Ophthalmology (Licence: NE 18881) | |
| 207W00000X Ophthalmology (Licence: MA 156104) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2025-07-08 |