| NPI | 1225038565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX E9467) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR N5777) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2019-09-11 |