NPI | 1407037872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: FL ME113175) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.095080) |
207W00000X Ophthalmology (Licence: KY TP066) | |
207W00000X Ophthalmology (Licence: FL ME113175) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-11-14 |
Last Update Date | 2021-07-14 |