| NPI | 1891954772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A116550) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP1-0032047) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2021-12-15 |