| NPI | 1598150880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: GA 96287) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX S0770) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-07-22 |