| NPI | 1588906465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: TX S6992) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101261971) |
| 207W00000X Ophthalmology (Licence: DC MD044942) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: VA 0101261971) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2023-11-13 |