| NPI | 1164412029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: TX K4232) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX K4232) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX K4232) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2017-04-06 |