| NPI | 1295184539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: NC 2021-00712) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD469802) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2021-07-26 |