| NPI | 1114051661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO MDR4H61) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036084634) |
| 207W00000X Ophthalmology (Licence: IL 036084634) | |
| 207W00000X Ophthalmology (Licence: KY 29233) | |
| 207W00000X Ophthalmology (Licence: MO MDR4H61) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 29233) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2017-12-11 |