| NPI | 1871851832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-49877) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 265970) |
| 207W00000X Ophthalmology (Licence: TX R1318) | |
| 207W00000X Ophthalmology (Licence: MD P27859) | |
| 207W00000X Ophthalmology (Licence: MO 2024039732) | |
| 207WX0009X Ophthalmology Glaucoma Specialist (Licence: TX R1318) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2024-10-09 |