| NPI | 1457932139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A206439) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX V6406) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2026-09-18 |