| NPI | 1497729743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 0413520) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO R4073) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2014-07-15 |