| NPI | 1659753960 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036163372) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35147038) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-02-03 |