NPI | 1356341119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 045447) |
Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: GA 045447) |
207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: GA 045447) | |
Enumeration Date | 2005-07-22 |
Last Update Date | 2023-02-28 |