NPI | 1982982302 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 70154) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 70154) |
Enumeration Date | 2011-08-02 |
Last Update Date | 2025-08-14 |