| NPI | 1548498447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 28001) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE TEP 6012) |
| 207W00000X Ophthalmology (Licence: NC 2013-01027) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2026-01-30 |