| NPI | 1922269083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A120920) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX N6278) |
| Enumeration Date | 2008-06-21 |
| Last Update Date | 2016-07-28 |