NPI | 1619901238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA MD02900R) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A21991) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2019-02-04 |