| NPI | 1972009827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 98735) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 98735) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD210001930) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2024-05-22 |