| NPI | 1659373561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CO DR.0021442) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 21442) |
| 207W00000X Ophthalmology (Licence: CO 21442) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2017-03-30 |