| NPI | 1467814830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 008516) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ME DO2996) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2020-07-06 |