NPI | 1992799191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35-074140) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-07-4140-M) |
Enumeration Date | 2005-09-02 |
Last Update Date | 2020-03-25 |