| NPI | 1518598960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NY 338266-01) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: IA MD-53060) |
| 207W00000X Ophthalmology (Licence: IA MD-53060) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2025-09-09 |