| NPI | 1124581780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM MD2023-0405) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2023-0282) |
| 207W00000X Ophthalmology (Licence: IL 125.074274) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-11-15 |