| NPI | 1396719399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0102201762) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102201762) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-12-21 |