| NPI | 1447284880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 20599) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO R3K23) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2012-09-14 |