| NPI | 1881697910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: CO DR.0063668) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A95007) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2022-03-30 |