| NPI | 1538180146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR0053398) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 38893) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-04-07 |