| NPI | 1205097607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036-123299) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 241050) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2013-01-10 |