| NPI | 1023472560 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A155838) | 
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036.153318) | 
| Enumeration Date | 2016-04-11 | 
| Last Update Date | 2022-10-25 |