| NPI | 1821201351 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A120894)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2009008059)  | 
| 207W00000X Ophthalmology (Licence: IL 036125717)  | |
| Enumeration Date | 2007-05-08 | 
| Last Update Date | 2013-02-18 |