| NPI | 1912137662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR0059142) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A124594) |
| 207W00000X Ophthalmology (Licence: NC 2014-01495) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2021-06-17 |