| NPI | 1346000106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL TRN39033) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 109478) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2026-06-05 |