| NPI | 1275603672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IL 046007180) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: IL 046007180) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2007-11-20 |