NPI | 1912312406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC LL38056) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R-10120) |
Enumeration Date | 2014-06-24 |
Last Update Date | 2022-02-21 |