| NPI | 1588661920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR27698) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-23793) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2013-04-08 |