| NPI | 1437446333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010430) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: IL 046010430) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2019-03-25 |