NPI | 1275542409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX 5899TG) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NH 0814) |
Enumeration Date | 2006-08-05 |
Last Update Date | 2024-03-07 |