| NPI | 1760441240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 22281) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 22281) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2021-08-16 |