| NPI | 1487910691 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 9683468-1205) | 
| Additional Taxonomies | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: AR E10293) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-02 | 
| Last Update Date | 2023-02-28 |