| NPI | 1457310518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 31896) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 46566) |
| 207W00000X Ophthalmology (Licence: MT 10506) | |
| 207W00000X Ophthalmology (Licence: MO 2006012805) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2009-05-07 |