| NPI | 1942428867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N2649) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT189484) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2014-03-07 |