NPI | 1174502330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SD 604) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: SD 604) |
152WP0200X Optometrist, Pediatrics (Licence: SD 604) | |
152WS0006X Optometrist, Sports Vision (Licence: SD 604) | |
152WX0102X Optometrist, Occupational Vision (Licence: SD 604) | |
Enumeration Date | 2006-01-15 |
Last Update Date | 2008-01-25 |