| NPI | 1548234255 |
|---|---|
| Professional Name | GORDON EDGAR WUEBBOLT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD052930L) |
| Additional Taxonomies | 156FX1100X Technician/Technologist, Ophthalmic (Licence: PA MD052930L) |
| 156FX1100X Technician/Technologist, Ophthalmic (Licence: NY 219642-1) | |
| 207W00000X Ophthalmology (Licence: NY 219642-1) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: NY 219642-1) | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: PA MD052930L) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-10-13 |