| NPI | 1558380303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: LA 016354) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX M2383) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-04-07 |