| NPI | 1740515436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 31188) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ND PT 13527) |
| 207W00000X Ophthalmology (Licence: KS 04-36398) | |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2016-11-25 |