NPI | 1164840906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 84855) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301105302) |
390200000X Student in an Organized Health Care Education/Training Program | |
207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036.146605) | |
Enumeration Date | 2014-03-30 |
Last Update Date | 2020-03-23 |