| NPI | 1467867002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0060612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 6905) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2020-05-20 |