NPI | 1033371729 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010255) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003512A) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2012-12-07 |