| NPI | 1578942801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX T3830) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 125066143) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CT 64038) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2024-03-13 |