| NPI | 1215044128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 40920) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AK 538) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |