NPI | 1790149524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL 40415) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-07 |
Last Update Date | 2020-11-06 |