| NPI | 1902937923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME95390) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036-115366) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-17 |