| NPI | 1801393855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036.166365) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX T9917) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2024-09-05 |