| NPI | 1356566004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 46378) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CO DR.0046378) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2019-05-22 |