| NPI | 1356979801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036.170368) |
| Additional Taxonomies | 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: IL 036.170368) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207W00000X Ophthalmology (Licence: OH 35.152737) | |
| 207W00000X Ophthalmology (Licence: KY 60436) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-04-02 |