| NPI | 1689870164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: CO 50051) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 50051) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2017-04-06 |