| NPI | 1275579567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 0430052) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2001014975) |
| 207W00000X Ophthalmology (Licence: MO 2001014975) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: KS 0430052) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: MO 2001014975) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2022-08-26 |