| NPI | 1013250240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0061712) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD182284) |
| 207W00000X Ophthalmology (Licence: CO DR.0061712) | |
| Enumeration Date | 2013-04-06 |
| Last Update Date | 2022-03-30 |