| NPI | 1033619630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0100774) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PR 15545) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 4959921) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2024-07-19 |