| NPI | 1891183273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: VA 0101275407) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207W00000X Ophthalmology (Licence: NC 2021-01619) | |
| 207W00000X Ophthalmology (Licence: VA 0101275407) | |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2022-06-20 |