| NPI | 1134122153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 66654) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX J2100) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2024-04-22 |