NPI | 1033189501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: SC 28369) |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 51916) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2022-09-06 |