| NPI | 1154313419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: CO DR.0029112) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 29112) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2017-10-25 |