| NPI | 1346477114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD465347) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX P0519) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2018-09-18 |