| NPI | 1275858656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 21873) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0053423) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2021-09-14 |