| NPI | 1003318569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX T7498) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 02005951A) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2024-12-31 |