| NPI | 1972569382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-44501) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR E0342) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2021-05-20 |