| NPI | 1073774121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0051109) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO CO-51109) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2017-04-06 |