| NPI | 1619927787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD038426E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C10004647) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |