| NPI | 1306805445 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: TX L5601) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX L5601) | 
| Enumeration Date | 2006-03-18 | 
| Last Update Date | 2018-04-09 |