NPI | 1376971556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME121631) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 73461) |
Enumeration Date | 2013-10-24 |
Last Update Date | 2024-08-06 |