| NPI | 1366292740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 84192) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: CT 84912) | |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2026-07-17 |