| NPI | 1447485461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301102705) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301102705) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2024-07-30 |