| NPI | 1740668094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: TX R0504) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX R0504) |
| 207W00000X Ophthalmology (Licence: MI 4301501696) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2025-11-04 |