NPI | 1275848962 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003759) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5936) |
Enumeration Date | 2010-08-18 |
Last Update Date | 2018-08-14 |