| NPI | 1336553874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CO DR0061743) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 5859-851) |
| 207W00000X Ophthalmology (Licence: CO DR0061743) | |
| 207W00000X Ophthalmology (Licence: MI 4301105291) | |
| 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: MI 4301105291) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2021-10-13 |