| NPI | 1871851832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX R1318) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207W00000X Ophthalmology (Licence: MD P27859) | |
| 207W00000X Ophthalmology (Licence: MA 265970) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: TX R1318) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2022-07-21 |