NPI | 1568491017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: AL 15903) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 15903) |
Enumeration Date | 2006-06-30 |
Last Update Date | 2019-10-18 |