| NPI | 1104862838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WV 26518) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: MD D0067034) |
| 173000000X Legal Medicine (Licence: DE C1-0008687) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2022-04-05 |