| NPI | 1104902683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CO 43772) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 43772) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2018-05-10 |