NPI | 1366475378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101256812) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 194774) |
207W00000X Ophthalmology (Licence: OH 35.135629) | |
Enumeration Date | 2006-07-10 |
Last Update Date | 2021-07-19 |