| NPI | 1174194955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX V9664) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX V9664) |
| 207W00000X Ophthalmology (Licence: IL 036155679) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036.155679) | |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2025-10-01 |