| NPI | 1578918066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 70313) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2020-0842) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2023-09-25 |