| NPI | 1316408974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0100037) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.073825) |
| 207W00000X Ophthalmology (Licence: TX U2938) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10072631) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2024-07-01 |