| NPI | 1043256811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N8222) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 186738-1205) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2013-04-09 |