| NPI | 1679968580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0065385) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0065385) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2026-08-20 |