| NPI | 1851382220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 20422) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX K0871) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2011-04-12 |