Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TA1387 | MD |
NPI | 1013089507 |
---|---|
Provider Name | Dr. William L Kranzer |
First Address | Rockville, MD 20852-4908 |
Second Address | Largo, MD 20774-5374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U88214 | (02) |