| NPI | 1124372776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 34702) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036081363) |
| 207W00000X Ophthalmology (Licence: OK 11945) | |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |