| NPI | 1720571185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX V0492) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL52607) |
| 207W00000X Ophthalmology (Licence: IL 036.159790) | |
| 207W00000X Ophthalmology (Licence: TX BP10067768) | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-09-09 |