NPI | 1194719765 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX F3267) |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX F3267) |
Enumeration Date | 2005-09-09 |
Last Update Date | 2018-02-02 |