| NPI | 1134198930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 8905T) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: CA 8905T) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2019-12-31 |