| NPI | 1427092923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2001014599) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-27629) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-09-17 |