| NPI | 1093193625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX S7248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-45959) |
| 207R00000X Internal Medicine (Licence: TX 591996) | |
| 207W00000X Ophthalmology (Licence: IA MD-45959) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2020-09-17 |