NPI | 1417242975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A127933) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207W00000X Ophthalmology (Licence: MA 261891) | |
Enumeration Date | 2011-06-13 |
Last Update Date | 2024-08-30 |