| NPI | 1225070717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-27847) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301051175) |
| 207W00000X Ophthalmology (Licence: MO 116603) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 0427847) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KS 116603) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301051175) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2022-08-26 |