| NPI | 1356390546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: KS 04-21479) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 0421479) |
| 207W00000X Ophthalmology (Licence: MO R3N76) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2019-02-28 |