NPI | 1568705788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME140160) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY TP739) |
207W00000X Ophthalmology (Licence: IA R-09930) | |
207W00000X Ophthalmology (Licence: OH 35131152) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-06 |
Last Update Date | 2019-08-06 |