| NPI | 1780144519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL 174281) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 86206) |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: FL 174281) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-09-10 |