| NPI | 1265726905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 48208) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY R2686) |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: KY 48208) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-29 |
| Last Update Date | 2017-11-28 |