| NPI | 1144781378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: MO 2023015292) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: IL 036164461) |
| 207WX0107X Ophthalmology Retina Specialist (Licence: TX V5605) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-05-01 |