| NPI | 1205128352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: TN TN-55555) |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: TN MD-55555) |
| 207W00000X Ophthalmology (Licence: TX q2364) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2023-08-14 |