NPI | 1225449317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: LA 330501) |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MS 25063) |
Enumeration Date | 2014-05-12 |
Last Update Date | 2022-12-09 |