| NPI | 1144297060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35075599G) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 75599) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2021-07-28 |