| NPI | 1801901780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-33342) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 200300114) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-01-08 |