NPI | 1346209020 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2196) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MN 2196) |
Enumeration Date | 2006-03-21 |
Last Update Date | 2015-03-03 |