NPI | 1124022587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD10191) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD00025202) |
Enumeration Date | 2005-06-13 |
Last Update Date | 2007-07-13 |