| NPI | 1265728927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 12199013-1204) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM A-1979-16) |
| 207W00000X Ophthalmology (Licence: CO 0055146) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2023-10-10 |