NPI | 1821062803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101222087) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0045385) |
207W00000X Ophthalmology (Licence: DC MD30501) | |
207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD30501) | |
207W00000X Ophthalmology (Licence: VA 0101222087) | |
207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0045385) | |
Enumeration Date | 2006-02-15 |
Last Update Date | 2019-04-09 |