| NPI | 1952561870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX Q0693) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: TX Q0693) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2023-11-27 |