| NPI | 1518122035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036.127859) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 125.255051) |
| 207W00000X Ophthalmology (Licence: IL 125.051255) | |
| 207W00000X Ophthalmology (Licence: KY 43666) | |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2011-06-16 |