| NPI | 1225771660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-53002) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 39387) |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2026-07-13 |