NPI | 1982099115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A172267) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD466821) |
Enumeration Date | 2015-04-03 |
Last Update Date | 2021-08-19 |