| NPI | 1073870275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 2018-00308) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: SC 51933) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207W00000X Ophthalmology (Licence: AL 32655) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2026-05-15 |