NPI | 1982107702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 71637) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301506610) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-18 |
Last Update Date | 2024-05-20 |