| NPI | 1316492598 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX U9669) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207W00000X Ophthalmology (Licence: TX U9669) | |
| Enumeration Date | 2016-08-17 | 
| Last Update Date | 2024-04-25 |