| NPI | 1699121194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: IL 036.159412) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036.159412) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2022-07-26 |