| NPI | 1659940096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301513433) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301513433) |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: MI 4301513433) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351047386) | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-06-27 |