| NPI | 1366804809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0070833) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 88271) |
| 207W00000X Ophthalmology (Licence: CO DR.0070833) | |
| 207W00000X Ophthalmology (Licence: OH 57.029210) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2023-11-06 |