| NPI | 1316938970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD030312E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C10002601) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2017-03-21 |