NPI | 1437151719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 30914) |
Additional Taxonomies | 174400000X Specialist (Licence: KY 30914) |
207W00000X Ophthalmology (Licence: OH 35.067760) | |
174400000X Specialist (Licence: OH 35-06-7760-B) | |
Enumeration Date | 2005-06-01 |
Last Update Date | 2018-09-18 |