| NPI | 1245893866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX U4008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10066734) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2024-07-22 |