| NPI | 1821201088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 24476) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 27560) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2026-05-26 |