NPI | 1326257569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A114509) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME103981) |
207W00000X Ophthalmology (Licence: CA A114509) | |
207W00000X Ophthalmology (Licence: MI 4301088814) | |
Enumeration Date | 2007-05-22 |
Last Update Date | 2021-04-05 |