| NPI | 1831326552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 47120) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207W00000X Ophthalmology (Licence: IN 01072743A) | |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2015-01-26 |