| NPI | 1164877031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: CO DR.0072676) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 287077) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-04-03 |