NPI | 1497284731 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 296424) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME MD22505) |
207W00000X Ophthalmology (Licence: MO 2023011649) | |
Enumeration Date | 2017-06-09 |
Last Update Date | 2023-04-20 |