| NPI | 1295997351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0055856) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NV 14844) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2020-04-20 |