| NPI | 1437538956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: MO 2020021798) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA LT000840) |
| 207W00000X Ophthalmology (Licence: MO 2020021798) | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: MO 2020021798) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2022-10-27 |