| NPI | 1285898221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 55950) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 39522) |
| 207W00000X Ophthalmology (Licence: WI 57737-20) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MN 55950) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: WI 57737-20) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2008012448) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2021-02-02 |