| NPI | 1548581374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA MD-41728) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-8977) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2023-11-27 |