NPI | 1134462161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: GU M-2201) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2016-0346) | |
Enumeration Date | 2013-03-28 |
Last Update Date | 2020-08-11 |