| NPI | 1639148711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX L4683) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA MD.023206) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2017-05-12 |