| NPI | 1881621209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-17640) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 35062) |
| 207W00000X Ophthalmology (Licence: MI 4301047588) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2011-01-06 |