| NPI | 1083145775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NY 309854) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 309854) |
| 207W00000X Ophthalmology (Licence: LA 333840) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-02-21 |