| NPI | 1326013251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04 30820) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2004017834) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2018-12-11 |