NPI | 1124422175 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL OS16652) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 5101024470) |
207WX0107X Ophthalmology, Retina Specialist (Licence: MI 5101024470) | |
Enumeration Date | 2014-10-20 |
Last Update Date | 2023-03-22 |