| NPI | 1922340066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME130999) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036.149834) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2022-05-19 |