NPI | 1356871230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NY 311158) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 311158) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-06-14 |
Last Update Date | 2023-10-11 |