NPI | 1316141872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO 45751) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 45751) |
Enumeration Date | 2007-06-11 |
Last Update Date | 2020-03-10 |