NPI | 1558555870 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A108989) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX M8082) |
Enumeration Date | 2007-08-29 |
Last Update Date | 2021-12-15 |