| NPI | 1922090174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD426245) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX M6718) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2023-04-11 |