NPI | 1265506224 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002070) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046 007909) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2022-10-26 |