| NPI | 1134270390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 6794) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 21459) |
| 207W00000X Ophthalmology (Licence: KS 22808) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2007-07-08 |