| NPI | 1023388162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX Q6581) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: TX 557944) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2016-06-21 |