NPI | 1225313372 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NV 811) |
Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: NV 811) |
152WV0400X Optometrist, Vision Therapy (Licence: NV 811) | |
Enumeration Date | 2011-10-19 |
Last Update Date | 2025-01-27 |