NPI | 1275763369 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: IA MD-42656) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 53448) |
207W00000X Ophthalmology (Licence: WA MD60309754) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-07-23 |
Last Update Date | 2025-06-17 |