| NPI | 1205360062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: MI 4301506698) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2021-00998) |
| 207W00000X Ophthalmology (Licence: PA MT214997) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2022-06-28 |