NPI | 1669655213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: OR MD173218) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD173218) |
Enumeration Date | 2007-12-06 |
Last Update Date | 2021-02-20 |