NPI | 1073661724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: TN 1972) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0601000923) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2007-07-09 |