| NPI | 1144304213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 58913) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX U3707) |
| 207W00000X Ophthalmology (Licence: CA A73850) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-10-02 |