| NPI | 1942427901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NV DO3550) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD H51434) |
| 207W00000X Ophthalmology (Licence: PA OS021716) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-12-01 |