NPI | 1487148243 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 33128) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 5151009600) |
207WX0107X Ophthalmology Retina Specialist (Licence: MS 33128) | |
Enumeration Date | 2018-06-15 |
Last Update Date | 2024-07-10 |