| NPI | 1053306001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35-08-5811-K) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 42080) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2008-02-08 |