| NPI | 1811492432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX V1285) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 125.072705) |
| 207W00000X Ophthalmology (Licence: NC 2022-00965) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-05-24 |