NPI | 1992330021 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A201612) |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A201612) |
Enumeration Date | 2020-03-09 |
Last Update Date | 2025-07-08 |