NPI | 1558380303 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: LA 016354) |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX M2383) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2017-04-07 |