| NPI | 1437163664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME90525) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX M2915) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-03-07 |