| NPI | 1639496953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A131213) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP20036802) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2023-07-10 |