| NPI | 1811576549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: CA A201964) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A201964) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 00) | |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2025-07-03 |