NPI | 1255317780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT8724T) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 8724) |
Enumeration Date | 2005-12-16 |
Last Update Date | 2018-11-13 |