NPI | 1114032687 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD26783) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD26783) |
Enumeration Date | 2006-08-21 |
Last Update Date | 2017-11-01 |