| NPI | 1689633638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-33631) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: KS 04-33631) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: UT 10260037-1205) | |
| 207W00000X Ophthalmology (Licence: FL ME0052066) | |
| 207W00000X Ophthalmology (Licence: CA G56961) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2022-10-28 |