NPI | 1235547209 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00659901) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00659900) |
Enumeration Date | 2014-07-23 |
Last Update Date | 2024-11-27 |