| NPI | 1316301583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 42849) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101262949) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2024-03-19 |