NPI | 1548204555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: OH 35028216) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35028216) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2020-12-01 |