| NPI | 1013989706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX J8262) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0043510) |
| 207W00000X Ophthalmology (Licence: OR MD18288) | |
| 207W00000X Ophthalmology (Licence: WA MD60650165) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX J8262) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2023-12-18 |