| NPI | 1821228677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04--37827) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2013021811) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2016-10-06 |