| NPI | 1699149500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2024016762) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036168884) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2024-09-03 |