NPI | 1043203565 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: TN 2244) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IA 2610) |
Enumeration Date | 2005-08-30 |
Last Update Date | 2023-03-07 |