| NPI | 1245395045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NH NH237) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH NH0237) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2008-07-08 |