| NPI | 1366576399 |
|---|---|
| Other Name | THAD DANIEL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 2359) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2396) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2025-03-19 |