| NPI | 1033435318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-43912) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2019017101) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2021-11-08 |