| NPI | 1770711889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 58209) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0012198) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-04-28 |