| NPI | 1235690264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036.164726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.074643) |
| 207W00000X Ophthalmology (Licence: IL 125.074643) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2023-07-09 |