| NPI | 1013129725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 71281) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036.120757) |
| 207W00000X Ophthalmology (Licence: OH 35.096094) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2017-02-28 |