| NPI | 1750968723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0074975) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0074975) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-06-02 |