NPI | 1861887473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD.61394322) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301117497) |
207W00000X Ophthalmology (Licence: OR MD205310) | |
Enumeration Date | 2015-03-31 |
Last Update Date | 2023-07-01 |