NPI | 1306972765 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC1256) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001759B) |
Enumeration Date | 2007-02-27 |
Last Update Date | 2022-11-29 |