| NPI | 1760618250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N4836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 533252) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2023-12-01 |