| NPI | 1811990039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0047810) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0004945) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2021-03-08 |