| NPI | 1164652178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35129579) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: OH 129579) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2021-02-23 |