NPI | 1740713643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME148138) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME148138) |
Enumeration Date | 2017-04-06 |
Last Update Date | 2024-09-13 |