| NPI | 1104388826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX U4917) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX U4917) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10071184) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2023-07-20 |