| NPI | 1033155338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO R2F29) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-22313) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2019-09-17 |