NPI | 1265446751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NV 554) |
Additional Taxonomies | 152W00000X Optometrist (Licence: UT 9848901-9934) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2016-06-29 |