NPI | 1043742695 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: CA A159963) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-04-03 |
Last Update Date | 2021-06-10 |