NPI | 1801030234 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WY 2699A) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 22033) |
Enumeration Date | 2009-04-29 |
Last Update Date | 2009-04-29 |