| NPI | 1881328268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: MI 4301511951) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4352001083) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2024-08-29 |