| NPI | 1770078859 |
|---|---|
| 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 LL52722) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2019-06-06 |