| NPI | 1154958171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2024007822) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036168584) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-09-03 |