| NPI | 1851384119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 0424668) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO MD110319) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2023-08-11 |