NPI | 1174020689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 19894) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA 20A19894) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-11 |
Last Update Date | 2022-07-06 |