NPI | 1679595128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO0085) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 0085) |
207W00000X Ophthalmology (Licence: FL OS3199) | |
Enumeration Date | 2006-07-24 |
Last Update Date | 2022-04-06 |