| NPI | 1588975130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-37390) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 57512-20) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2016-04-19 |