| NPI | 1184762577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX Q4846) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY R0822) |
| 207W00000X Ophthalmology (Licence: MD D0066175) | |
| 207W00000X Ophthalmology (Licence: IA 38424) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX Q4846) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2024-08-07 |