NPI | 1235130402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 16167) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 16167) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2019-05-07 |