| NPI | 1518971233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0055310) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101044346) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2018-03-17 |