NPI | 1376513366 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV004870) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY TUV004870) |
Enumeration Date | 2006-01-24 |
Last Update Date | 2014-08-19 |