NPI | 1629081435 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD20893) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD00036997) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2015-08-22 |