| NPI | 1407291420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: TX R5656) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME130916) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2025-04-29 |