NPI | 1518353168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: LA 325976) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35135633) |
207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35135633) | |
Enumeration Date | 2015-04-10 |
Last Update Date | 2021-08-25 |