NPI | 1639104318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME79154) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 210778-1) |
207W00000X Ophthalmology (Licence: CA G83074) | |
Enumeration Date | 2006-07-11 |
Last Update Date | 2022-04-05 |