| NPI | 1699236943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0070305) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0070305) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-02-11 |