| NPI | 1467076679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ R78547) |
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: NY 328901) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT221037) | |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2024-04-06 |