| NPI | 1346444940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N8883) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101246572) |
| 207W00000X Ophthalmology (Licence: TX BP1-0022227) | |
| 207W00000X Ophthalmology (Licence: AZ 38126) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-02-25 |