| NPI | 1063412161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD04219IL) |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: PA MD042191L) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2017-05-01 |