| NPI | 1548587769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX Q9382) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO dr.0053359) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2016-0149) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2020-06-17 |