NPI | 1275039638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 102979) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 57744) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-04 |
Last Update Date | 2025-07-29 |