| NPI | 1255530762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: GA 70909) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301095612) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2023-11-06 |