| NPI | 1205911260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: KS 1455-3) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: KS 1455) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: MO T03213) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-06-12 |