| NPI | 1750841383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC LL82611) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2020-04-27 |