NPI | 1144330242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2740) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046009067) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2023-07-21 |