NPI | 1912994658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 34394) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: RI MD05069) |
Enumeration Date | 2005-09-27 |
Last Update Date | 2015-09-21 |