| NPI | 1750382487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME0068633) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME68633) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2018-05-10 |