| NPI | 1346303153 |
|---|---|
| Former Name | SAMUEL HAIRE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1222) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1276DT) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2019-04-08 |