NPI | 1235738634 |
---|---|
Entity Type | Organization |
Authorized Contact | JORDAN BURNHAM Owner 225-523-7624 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist |
Enumeration Date | 2020-10-19 |
Last Update Date | 2022-05-18 |