| NPI | 1285195602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX U2461) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10067159) |
| 207W00000X Ophthalmology (Licence: TX BP20072626) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-08-28 |