NPI | 1346403961 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 66356) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 275254) |
207W00000X Ophthalmology (Licence: FL ME112267) | |
Enumeration Date | 2008-07-03 |
Last Update Date | 2021-02-01 |