NPI | 1346327301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: DE I30001211OS) |
Additional Taxonomies | 152W00000X Optometrist (Licence: DE G000697PA) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2020-08-13 |