NPI | 1881691335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 19486) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME58780) |
207WX0107X Ophthalmology, Retina Specialist (Licence: CA A39159) | |
208000000X Pediatrics (Licence: CA A39159) | |
Enumeration Date | 2005-06-30 |
Last Update Date | 2023-12-27 |