| NPI | 1245592625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD181538) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 283073) |
| 207WX0120X Ophthalmology Cornea and External Diseases Specialist (Licence: OR MD181538) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2020-10-22 |