| NPI | 1427340215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX R6025) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 26879) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2022-07-21 |