NPI | 1558990846 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: PA LT000884) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-07 |
Last Update Date | 2021-07-22 |