NPI | 1912168105 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME112395) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-054586) |
Enumeration Date | 2008-06-19 |
Last Update Date | 2012-06-25 |