| NPI | 1033403100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX S5607) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 41577) |
| 207W00000X Ophthalmology (Licence: TX S5607) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: IA 41577) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2020-12-16 |