NPI | 1508241209 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO TL.0005920) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MTL002799) |
207W00000X Ophthalmology (Licence: VA 0116028520) | |
Enumeration Date | 2015-07-23 |
Last Update Date | 2016-06-30 |