| NPI | 1235799024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: NC 2024-01420) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 67797) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2024-06-18 |