| NPI | 1457001489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 012274) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 58.032632) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2026-05-19 |