| NPI | 1083608491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: NH 0434) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH 0434) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-11-09 |