| NPI | 1013106244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 5201T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 520IT) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2024-06-12 |