NPI | 1376507111 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX L3731) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD426415) |
Enumeration Date | 2006-04-17 |
Last Update Date | 2019-03-20 |