| NPI | 1720374994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR0057115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT-198878) |
| 207W00000X Ophthalmology (Licence: PA MD453992) | |
| Enumeration Date | 2011-06-25 |
| Last Update Date | 2016-08-04 |