NPI | 1679731590 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A109505) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD456377) |
207W00000X Ophthalmology (Licence: CO DR.0067286) | |
Enumeration Date | 2008-05-28 |
Last Update Date | 2021-11-09 |