| NPI | 1073585352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY TUV-008818) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CO 2051) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2024-04-23 |