| NPI | 1912909706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A100573) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036109175) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-02-10 |