NPI | 1225531676 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9326T) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 9326T) |
152WX0102X Optometrist, Occupational Vision (Licence: TX 9326T) | |
152WP0200X Optometrist, Pediatrics (Licence: TX 9326T) | |
Enumeration Date | 2018-03-12 |
Last Update Date | 2020-11-24 |