| NPI | 1598095085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX CE00007) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX FTL42925) |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2023-01-26 |