| NPI | 1932841160 |
|---|---|
| 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: KY 61837) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2026-04-07 |