| NPI | 1952367351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036-069820) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 036069820) |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: IL 036069820) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2009-11-20 |