| NPI | 1508998576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX S4690) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 6207901-1205) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2024-07-12 |