| NPI | 1679860225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0059828) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD180842) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2022-07-21 |