| NPI | 1104827351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: TX K9978) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 33235) |
| 207W00000X Ophthalmology (Licence: NM 2002-0262) | |
| 207W00000X Ophthalmology (Licence: TX K9978) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-09-20 |