| NPI | 1366749343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX R9361) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 125486) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2024-02-28 |