| NPI | 1265695357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010189) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 13514TLG) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2023-07-13 |