| NPI | 1659346245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: KS 04-21085) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 0421085) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2018-01-29 |