| NPI | 1750325080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-30624) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2006024383) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2006024383) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KS 04-30624) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2022-09-01 |