| NPI | 1538427471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 10124037) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: AL 35068) |
| 207W00000X Ophthalmology (Licence: AL 35068) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10044252) | |
| Enumeration Date | 2012-04-29 |
| Last Update Date | 2018-08-29 |