NPI | 1629051420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 28366) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 6152) |
Enumeration Date | 2005-11-25 |
Last Update Date | 2013-11-25 |