NPI | 1730150822 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: LA MD.10157R) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA 10157R) |
Enumeration Date | 2006-01-27 |
Last Update Date | 2022-09-20 |