| NPI | 1053349530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: CO DR.0041242) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 41242) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2018-09-01 |