| NPI | 1114117769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX P3901) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036125974) |
| 207W00000X Ophthalmology (Licence: LA MD.201807) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2020-06-11 |