| NPI | 1285618520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD483918) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX K5541) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2024-07-24 |