| NPI | 1003345786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 71871) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09283) |
| 207W00000X Ophthalmology (Licence: KS 94-09283) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2022-07-19 |