NPI | 1760944185 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 327024) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME161779) |
Enumeration Date | 2019-04-03 |
Last Update Date | 2024-08-19 |