NPI | 1740867449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2025030497) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-51062) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-03-27 |
Last Update Date | 2025-08-12 |