NPI | 1497195267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD461967) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 06303) |
207W00000X Ophthalmology (Licence: NM RS2016-0706) | |
Enumeration Date | 2013-06-26 |
Last Update Date | 2019-01-15 |