| NPI | 1083795892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.089404) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-089404) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-12-31 |