| NPI | 1508998576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 76662) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2023-1594) |
| 207W00000X Ophthalmology (Licence: UT 6207901-1205) | |
| 207W00000X Ophthalmology (Licence: TX S4690) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2025-06-02 |