NPI | 1275781841 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: OH 5820 T2734) |
Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4380) |
Enumeration Date | 2008-09-08 |
Last Update Date | 2023-09-25 |