NPI | 1447299904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-35632) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2318) |
152W00000X Optometrist (Licence: KS 1588) | |
207W00000X Ophthalmology (Licence: NE 6489) | |
207W00000X Ophthalmology (Licence: MO 2007019126) | |
Enumeration Date | 2006-06-06 |
Last Update Date | 2012-10-15 |