| NPI | 1669869848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A188582) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A188582) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2025-05-16 |