NPI | 1619978756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: PA MD428569) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD428569) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2019-02-27 |