NPI | 1346655099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 007053) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A13378) |
Enumeration Date | 2014-06-20 |
Last Update Date | 2018-05-15 |