| NPI | 1811126105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX P2276) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX 532715) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2023-03-07 |