| NPI | 1477680098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA 17526) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0024551) |
| 207W00000X Ophthalmology (Licence: IA 17526) | |
| 208600000X Surgery (Licence: MD D0024551) | |
| 208D00000X General Practice (Licence: MD D0024551) | |
| 208D00000X General Practice (Licence: IA 17526) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2025-09-11 |