| NPI | 1952894966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CO DR.0070480) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX T5850) |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: NM MD2023-0361) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-06-26 |