NPI | 1043891971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NE 35582) |
Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: NE 35582) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4352001016) | |
Enumeration Date | 2021-04-21 |
Last Update Date | 2023-08-10 |