| NPI | 1396731006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME EL-05-010) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AR E-12105) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2022-05-16 |