NPI | 1861711558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC MD37781) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301096321) |
207W00000X Ophthalmology (Licence: NC 2015-00277) | |
207W00000X Ophthalmology (Licence: TN MD51142) | |
Enumeration Date | 2010-05-20 |
Last Update Date | 2023-06-27 |