| NPI | 1932594991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 29476) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 29476) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2025-09-16 |