| NPI | 1518407600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL 37355) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AL 37355) |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2024-05-09 |