| NPI | 1205834439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0054602) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD22302) |
| 207W00000X Ophthalmology (Licence: CA 75599) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2018-12-20 |