| NPI | 1942580253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: CA A118884) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A118884) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A118884) | |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2025-06-02 |