| NPI | 1538504469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 144812) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX Q9748) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2021-08-25 |