NPI | 1760847925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: FL ME135227) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: ZZ 08RM0049782) |
207W00000X Ophthalmology (Licence: FL MFC1751) | |
Enumeration Date | 2015-12-15 |
Last Update Date | 2021-01-25 |