| NPI | 1982673430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: TX H9997) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX H9997) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: TX H9997) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2024-04-24 |