| NPI | 1306280086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI 19493) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 28030) |
| 208D00000X General Practice (Licence: NE 28030) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2021-07-19 |