| NPI | 1992199970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: SC 85097) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD60858876) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2025-10-07 |