| NPI | 1174752935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology Glaucoma Specialist (Licence: CO DR.0052296) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 52296) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2017-04-06 |