NPI | 1760826895 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 50212) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY R3191) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: KY R3191) | |
Enumeration Date | 2013-04-19 |
Last Update Date | 2022-11-17 |