| NPI | 1891832143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: CO DR.0046595) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0046595) |
| 207W00000X Ophthalmology (Licence: WA MD6014746) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-03-29 |