| NPI | 1720492820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: OR MD193169) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CA A155530) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-04-10 |