| NPI | 1346535168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 136502) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP10043765) |
| 208600000X Surgery (Licence: HI MDR-6092) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2021-12-08 |