| NPI | 1164809851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A144479) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0025611) |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: CA A144479) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2023-07-24 |