| NPI | 1013437029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0070550) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2021-01255) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2023-07-19 |