| NPI | 1275531360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 29492) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-15780) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-06-07 |