NPI | 1215228036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2022-00189) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD457242) |
207WX0107X Ophthalmology, Retina Specialist (Licence: KY 51521) | |
Enumeration Date | 2011-04-27 |
Last Update Date | 2022-04-06 |