| NPI | 1023167681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME69249) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 69249) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2018-09-12 |