| NPI | 1841786829 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151010511) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR DO209577) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2022-07-08 |