NPI | 1255330254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1108) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NC 1108) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2020-11-06 |