NPI | 1962504514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 297470) |
Additional Taxonomies | 174400000X Specialist (Licence: GA 032186) |
Enumeration Date | 2006-09-03 |
Last Update Date | 2021-08-05 |