| NPI | 1609313774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 1895) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2021035719) |
| 208D00000X General Practice (Licence: NE 1895) | |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2024-06-25 |