| NPI | 1548324288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM MD2019-0490) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX P8428) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2019-10-09 |