NPI | 1215322573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 1540) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX T3764) |
Enumeration Date | 2015-04-03 |
Last Update Date | 2024-05-25 |