| NPI | 1972612661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 29041) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036-095176) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |