NPI | 1629638374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: PA MT219051) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT219051) |
Enumeration Date | 2019-06-15 |
Last Update Date | 2019-06-15 |