NPI | 1073689253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101229044) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD15560) |
207W00000X Ophthalmology (Licence: MD D0054382) | |
Enumeration Date | 2006-11-28 |
Last Update Date | 2021-06-22 |