NPI | 1366708174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME136871) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL MD.32701) |
Enumeration Date | 2012-04-05 |
Last Update Date | 2018-09-14 |