NPI | 1366411233 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD045344E) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA05351700) |
207W00000X Ophthalmology (Licence: PA MD046344E) | |
Enumeration Date | 2006-03-14 |
Last Update Date | 2020-08-24 |