NPI | 1134515042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: SC 85225) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 85225) |
207WX0107X Ophthalmology, Retina Specialist (Licence: TN 59011) | |
Enumeration Date | 2015-04-08 |
Last Update Date | 2024-10-07 |