NPI | 1710220330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61042379) |
Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: WA MD61043249) |
Enumeration Date | 2013-04-02 |
Last Update Date | 2020-06-03 |