| NPI | 1346276235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO R4P23) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-28135) |
| 207W00000X Ophthalmology (Licence: LA MD.019476) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2019-09-17 |