| 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 |