NPI | 1083069926 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MN 69015) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 69015) |
Enumeration Date | 2016-04-28 |
Last Update Date | 2024-06-04 |