| NPI | 1821747742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 11022461) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: KY TP932) | |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2026-04-15 |