| NPI | 1275119661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX V7489) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 125.078712) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2025-08-12 |