| NPI | 1982876256 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: KY 46941) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 46941) | 
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: OH 127828) | |
| Enumeration Date | 2008-03-27 | 
| Last Update Date | 2016-05-18 |