| NPI | 1528386430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101258625) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101258625) | |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2023-08-09 |