| NPI | 1871853077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX R1256) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A142273) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX R1256) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2022-06-02 |