| NPI | 1801901988 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 29252) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 36068941) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-01-05 |