| NPI | 1306182134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CO OPT.0003639) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: IL 046007939) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2021-08-12 |