| NPI | 1548235476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 0422448) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO R8F92) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2022-08-23 |