| NPI | 1649665241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX T7876) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IN 01082191A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-09-21 |