| NPI | 1396937074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: UT 8227125-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD154095) |
| 207W00000X Ophthalmology (Licence: UT 8227125-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL17376) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2018-06-28 |