NPI | 1285830323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: RI MD14427) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2009-00806) |
207W00000X Ophthalmology (Licence: OH 57.009639) | |
207W00000X Ophthalmology (Licence: WA MD60157794) | |
Enumeration Date | 2007-06-25 |
Last Update Date | 2021-05-20 |