NPI | 1629463732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME145554) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA10624000) |
Enumeration Date | 2015-04-06 |
Last Update Date | 2023-09-27 |