| NPI | 1730149550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME154015) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036085447) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-10-10 |