| NPI | 1003872359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036134025) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 248001) |
| 207W00000X Ophthalmology (Licence: WA MD60294408) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60294408) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 248001) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2021-10-20 |