| NPI | 1528581527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046011248) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3401) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2024-05-20 |