NPI | 1700860905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 192271) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 159550) |
Enumeration Date | 2005-12-01 |
Last Update Date | 2025-08-19 |