| NPI | 1730180886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: KS 04-21215) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 0421215) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2021-04-07 |