| NPI | 1962852889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2020011232) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 036152929) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2023-06-28 |