| NPI | 1902023088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036123759) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: RI LP00389) |
| 207W00000X Ophthalmology (Licence: NY 247724) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2010-02-18 |