NPI | 1508853128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61123922) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C160209) |
Enumeration Date | 2005-09-29 |
Last Update Date | 2021-08-30 |