| NPI | 1790147155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-13044) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: AR E13044) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AR E-13044) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2023-07-11 |