NPI | 1649267253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO R6E34) |
Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MO R6E34) |
Enumeration Date | 2005-09-29 |
Last Update Date | 2022-03-14 |