| NPI | 1538171921 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 36117039)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 241356)  | 
| 207W00000X Ophthalmology (Licence: MO 2013007992)  | |
| Enumeration Date | 2006-08-13 | 
| Last Update Date | 2013-04-03 |