| NPI | 1760844906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX S5515) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: IA MD-48350) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2024-06-04 |