NPI | 1376766816 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101051247) |
Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101051247) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2019-02-24 |