| NPI | 1659607406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DE C1-0011414) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD442779) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2022-07-28 |