NPI | 1215929989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC001791) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: FL OPC001791) |
Enumeration Date | 2005-08-18 |
Last Update Date | 2010-07-01 |