NPI | 1477110799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC MD92000) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 13359512-1205) |
Enumeration Date | 2019-05-22 |
Last Update Date | 2024-09-12 |