NPI | 1629364054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: UT 11363238-1205) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 11363238-1205) |
207W00000X Ophthalmology (Licence: IN 01075209B) | |
207WX0107X Ophthalmology Retina Specialist (Licence: NV 19279) | |
Enumeration Date | 2011-06-23 |
Last Update Date | 2019-11-21 |