| NPI | 1033536396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: TX S0810) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX S0810) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2026-02-16 |