NPI | 1154980209 |
---|---|
Former Name | ADRIAN KUN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: VA 0618002770) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3287) |
152W00000X Optometrist (Licence: MA 5694) | |
Enumeration Date | 2019-06-12 |
Last Update Date | 2024-07-23 |