| NPI | 1164637153 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA 20A12784)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036122962)  | 
| 207W00000X Ophthalmology (Licence: CA 20A12784)  | |
| Enumeration Date | 2007-05-11 | 
| Last Update Date | 2017-04-05 |