| NPI | 1811384282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036159824) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 1811384282) |
| 207W00000X Ophthalmology (Licence: OH 35.135844) | |
| 207W00000X Ophthalmology (Licence: IA MD-47095) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2022-10-13 |