| NPI | 1518994631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-26713) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 111975) |
| 207W00000X Ophthalmology (Licence: UT 9713727-1205) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KS 0426713) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 111975) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: UT 9713727-1205) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-08-26 |