NPI | 1942205240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G84602) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301069854) |
207W00000X Ophthalmology (Licence: UT 358057-1205) | |
Enumeration Date | 2005-06-15 |
Last Update Date | 2023-03-07 |