NPI | 1699754069 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: CO 20179) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 20179) |
Enumeration Date | 2006-01-12 |
Last Update Date | 2016-07-23 |