NPI | 1003818600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 12594) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 217143) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2015-10-27 |