NPI | 1699758979 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 76765) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 76765) |
207W00000X Ophthalmology (Licence: NH 9469) | |
Enumeration Date | 2005-11-21 |
Last Update Date | 2013-11-25 |