| NPI | 1992782494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036082457) |
| Additional Taxonomies | 156FX1202X Technician/Technologist Optometric Technician (Licence: IL 036082457) |
| 207W00000X Ophthalmology (Licence: IN 01070796A) | |
| 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: IL 036082457) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-04-23 |