| NPI | 1437564846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 7480) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC LL37052) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2018-06-14 |