| NPI | 1679725550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 69458) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-054005) |
| 207W00000X Ophthalmology (Licence: IL 036130938) | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2023-10-31 |