| NPI | 1841871605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: NY 336449-01) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2025-08-05 |