NPI | 1962451336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WY 17263A) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 200000285) |
207W00000X Ophthalmology (Licence: SC 21706) | |
Enumeration Date | 2006-05-10 |
Last Update Date | 2025-03-18 |